Cited by 575Regulation of Appetite and ObesityAdipokines, Inflammation, and Metabolic DiseasesHypothalamic control of reproductive hormones

The DOI matches its Crossref record; 94 of the 98 references it cites were found in a registry or an index; none of the 95 sources its claims cite is checked for support yet.

Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight

Open access
Rosenbaum, M.·2005·Journal of Clinical Investigation

Abstract

Maintenance of a reduced body weight is accompanied by decreased energy expenditure that is due largely to increased skeletal muscle work efficiency. In addition, decreased sympathetic nervous system tone and circulating concentrations of leptin, thyroxine, and triiodothyronine act coordinately to favor weight regain. These "weight-reduced" phenotypes are similar to those of leptin-deficient humans and rodents. We examined metabolic, autonomic, and neuroendocrine phenotypes in 10 inpatient subjects (5 males, 5 females [3 never-obese, 7 obese]) under 3 sets of experimental conditions: (a) maintaining usual weight by ingesting a liquid formula diet; (b) maintaining a 10% reduced weight by ingesting a liquid formula diet; and (c) receiving twice-daily subcutaneous doses of leptin sufficient to restore 8 am circulating leptin concentrations to pre-weight-loss levels and remaining on the same liquid formula diet required to maintain a 10% reduced weight. During leptin administration, energy expenditure, skeletal muscle work efficiency, sympathetic nervous system tone, and circulating concentrations of thyroxine and triiodothyronine returned to pre-weight-loss levels. These responses suggest that the weight-reduced state may be regarded as a condition of relative leptin insufficiency. Prevention of weight regain might be achievable by strategies relevant to reversing this leptin-insufficient state.

Overview

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TL;DR

In 10 inpatient subjects, maintenance of a 10% reduced body weight produced coordinated declines in energy expenditure, skeletal muscle efficiency, sympathetic tone, and thyroid hormones. Low-dose leptin, titrated to restore 8 am leptin concentrations to pre-weight-loss levels, reversed many of these weight-reduced adaptations, suggesting the state is one of relative leptin insufficiency.

Key findings

  • At Wt−10%, 24-hour energy expenditure (TEE) and nonresting energy expenditure (NREE) fell out of proportion to body-composition changes; skeletal muscle gross mechanical efficiency at 10 W was approximately 23% higher than at Wtinitial, and glucose oxidation at 10 W fell by approximately 12%.
  • Leptin administration at Wt−10%lep restored TEE, NREE, skeletal muscle work efficiency, fuel utilization, sympathetic nervous system activity, urinary epinephrine, and circulating T4/T3 to pre-weight-loss levels; it did not significantly alter TSH, 24-hour urinary norepinephrine, parasympathetic activity, or intrinsic heart rate.
  • Mean total daily leptin dose was 0.068 ± 0.01 mg/kg (range 0.019–0.121 mg/kg/d) divided q12 hours; 8 am plasma leptin at Wt−10%lep was not significantly different from Wtinitial.
  • During leptin administration on an isocaloric diet, body weight and fat mass declined further; fat mass accounted for 67.2% ± 8.5% of weight lost during leptin, versus 71% ± 6.7% during the initial 800-kcal/d weight loss. No significant gender or initial somatotype effects were noted, except lean subjects lost 10% of weight faster (mean 6 weeks) than obese subjects (mean 9 weeks).

Methods

  • Ten subjects (5 male, 5 female; 3 never-obese, 7 obese; mean ± SEM age 32.2 ± 2.9 years) were studied as inpatients at three weight plateaus: usual weight (Wtinitial), 10% reduced weight (Wt−10%), and 10% reduced weight during 5 weeks of twice-daily subcutaneous recombinant human leptin (A-100; Amgen) titrated to restore 8 am leptin to Wtinitial levels (Wt−10%lep).
  • Measurements included body composition by DXA; energy expenditure by weight-maintenance caloric titration, indirect calorimetry, and calculated NREE; skeletal muscle work efficiency by graded bicycle ergometry; autonomic function by heart-rate analysis during pharmacological blockade and 24-hour urinary catecholamines; and neuroendocrine measures by ELISA/RIA.
  • Intragroup comparisons used repeated-measures ANOVA; between-group comparisons used ANOVA; significance was prospectively defined as P < 0.05.

Limitations

  • Stated in the paper: twice-daily exogenous leptin does not mimic normal leptin pulsatility, and effects of weight reduction or exogenous leptin on leptin pulsatility in humans had not been reported; therefore 8 am leptin concentrations may not reflect total daily leptin or pulsatility.
  • Stated in the paper: organ-specific autonomic measures do not necessarily reflect systemic autonomic nervous system tone; longer studies are needed to determine whether chronic leptin-axis reactivation helps maintain reduced body weight.
  • Evident from the text: the study had only 10 subjects, some energy-expenditure and thyroid data from 4 subjects had been reported previously, and the leptin phase lasted 5 weeks, limiting generalizability and long-term inference.

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Integrity signals

Registry

Crossref · 10.1172/jci25977

Cites

94 of 94 references verified0 citation errors · 0 not checkable

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  • It may state two separate claims as one. 32
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  • The quote only partly states this claim. 1
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  • The authors state this as an assumption.

    The threshold for determination of leptin sufficiency is determined by anatomic and functional characteristics of the hypothalamus and other parts of the brain that are, in turn, determined by genetic and developmental factors.

    “The threshold for determination of leptin sufficiency in this context is determined by anatomic and functional characteristics of the hypothalamus and other parts of the brain that are, in turn, determined by genetic and developmental factors.”
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Research works printed but not linked: 2

  1. Keesey, R.E. 1980. A set-point analysis of the regu- lation of body weight. In Obesity. A.J. Stunkard, editor. W.B. Saunders. Philadelphia, Pennsylvania, USA. 144-165.
  2. Miles, L. 1977. Chapter 4. In Handbook of radioimmu- noassay. G. Abraham, editor. Marcel Dekker. New York, New York, USA. 679-680.

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Metadata

Authors
Rosenbaum, M.
Affiliations
Columbia University Irving Medical Center (US)
Corresponding author
Rosenbaum, M.
Venue
Journal of Clinical Investigation
Published
2005-12-01
Volume
115
Issue
12
Pages
3579-3586
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2109742508
Cited by
575
References
98
Citations by year
2026: 12 · 2025: 18 · 2024: 14 · 2023: 21 · 2022: 14 · 2021: 22 · 2020: 14 · 2019: 27 · 2018: 26 · 2017: 30 · 2016: 34 · 2015: 38 · 2014: 45 · 2013: 32 · 2012: 33
FWCI
9.17
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Amgen
  • National Institutes of Health (DK26687, RR-00645)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK-26687, R01DK064773, DK64773, P30DK026687)
  • National Center for Research Resources (RR 00645, M01RR000645)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
leptin, weight maintenance, weight loss, weight regain, energy expenditure, sympathetic tone, thyroxine, triiodothyronine, neuroendocrine adaptation, leptin deficiency, obesity, liquid formula diet
MeSH terms
Adult, Body Composition, Body Weight, Energy Intake, Calorimetry, Diet, Reducing, Energy Metabolism, Female, Humans, Male, Neurosecretory Systems, Obesity, Phenotype, Thyroxine, Time Factors, Triiodothyronine, Weight Loss, Body Mass Index, Muscle, Skeletal, Leptin

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